How effective is bariatric surgery in early-onset type 2 diabetes?

This study compared the outcomes of bariatric surgery between patients with early onset (before age 40) and late onset (after age 40) type 2 diabetes. They found that bariatric surgery had more successful outcomes in those with early onset type 2 diabetes.

As the number of patients with type 2 diabetes (T2D) continues to rise, there is a greater number of people being diagnosed at younger ages (before the age of 40). Many patients with T2D respond poorly to the standard glucose-lowering medications and lifestyle interventions.

Bariatric surgery describes a number of surgeries used to promote weight loss and remission (normalized blood glucose levels) of T2DM. Surgeries may involve bypassing or removing a portion of the stomach or shrinking the stomach size using a gastric band. It is not clear whether timing of T2D onset affects the success of surgery.

This study compared patients with early and late onset T2D who underwent bariatric surgery. Patients had a BMI (body mass index; measure of body fat that takes height and weight into account) greater than 25.

Patients with early onset T2D showed a greater reduction in BMI and waist circumference after 1 year. Patients with early onset T2D were more likely to experience complete remission (56.9%) than patients with late onset (50.2%). Patients with early onset T2D were also less likely to require insulin and antidiabetic medicine 1 year after the surgery.

After 5 years, patients with early onset T2D showed greater weight loss and were more likely to still be in remission.

91.3% of early onset patients who had been diagnosed less than a year before the surgery experienced complete remission. However, just 25% of early onset patients who underwent surgery more than 10 years after diagnosis experienced complete remission.

This study concluded that bariatric surgery is more likely to be successful in patients with early onset T2D compared to late onset. 

This study was carried out on Taiwanese patients in just one institution. Results may differ for other ethnic groups and regions.

Consult with your physician regarding the risks and benefits of bariatric surgery.